Oral medicine

  • S. Gandalfo,
  • C. Scully &
  • M. Carrozzo
UK: Elsevier price £35.99, pp 195 ISBN 0443100373 | ISBN: 0-443-10037-3

The authors tell us that this book 'provides different levels of reading that should be useful to dental students, general practitioners, and specialists from related fields.' However, the text is not marked in a way that might help these categories of readers to know what is intended for each of them.

The text is comprehensive, well written and well presented, but there are deficiencies. Cross-referencing could have been better. For example, under 'other gingival hyperplasia' the reader is referred to Crohn's disease. However, the entry for the latter has no information on the gingival changes that might be expected. Similarly, the captions to some figures are inconsistent with the text. It is also rather surprising in an oral medicine text to find no entries for trigeminal neuralgia or orofacial granulomatosis. A colour-coding scheme differentiates conditions according to the level of expertise required for management. This is a clever and useful scheme. There are a number of good algorithms on the management of oral conditions. That for recurrent aphthous stomatitis seems to suggest that if the condition is recurrent (which is self-evident) then treatments such as thalidomide should be considered. This is sloppy editing and potentially dangerous in a text aimed at, amongst others, family doctors. I would be concerned that the section on drugs for the treatment of mucosal disease presents a number of agents in various groups without any strong sense of whether or not they would be appropriate first line treatments.

As much of the diagnostic process for diseases of the oral mucous membranes depends on a close evaluation of colour changes in the tissues, accurate colour rendition is essential in the illustrations; a good example is the excellent atlas of oral diseases that Professor Scully co-authors. Unfortunately the authors of the present work seem to have been let down by their publisher in this regard.

The teaching of oral medicine has long been complicated by the absence of good textbooks at undergraduate and specialist level. Most existing texts are too synoptic, or contain material that is controversial or the personal opinions of the authors, or have clinical illustrations that are not of adequate quality. I had hoped that this might be the text that would fill the gap in the market. Unfortunately it is not. I would be reluctant to recommend this text to undergraduates and would only recommend it to trainees as a supplementary text.